Provider Demographics
NPI:1326629882
Name:ADLER, JENNA (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12132 HENESON GARTH
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1600
Mailing Address - Country:US
Mailing Address - Phone:410-371-7750
Mailing Address - Fax:
Practice Address - Street 1:9199 REISTERSTOWN RD STE 202B
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4579
Practice Address - Country:US
Practice Address - Phone:410-371-7750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD253621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25362OtherSTATE LICENSE